Unknown Individual – Emergency Medicine Physician, NPI 1720073109

Emergency Medicine Physician

Unknown Individual is a healthcare provider. based in Vincennes, Indiana. specializing in Emergency Medicine Physician. They hold a License No. 01038476A (IN). The NPI Number for Unknown Individual is 1720073109

Main info

Organization

Inactive

41 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1720073109

Phone

(812) 885-3685

Address

520 S 7TH ST

Deactivation Date

17 January 2024

Doctor Profile

Medical School Name

WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

8129962345

Graduation Year

1985 (41 years ago)

PAC ID

3072657519

Group Practice PAC ID

4587578042

Professional Enrollment ID

I20100222000166

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

Good Samaritan Hospital, 520, South 7th Street, Vincennes, Knox County, Indiana, 47591, United States
VINCENNES, IN 475911038
Phone: (812) 885-3685
Fax: (812) 885-3917
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 47591)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4587578042View full group profile

Name	Specialty	State
MR. MICHAEL A WOHLBERG (MD)	Diagnostic Radiology	IN
DR. NIKOLA CENGELOVA CONRAD (M.D.)	Family Practice	MI
STEPHEN R. TOOTHAKER (M.D.)	Medical Oncology, Hematology/Oncology	MO
MRS. HEATHER L. TERWISKE (MSW, LSW)	Clinical Social Worker	IN
KARIM ANWAR (M.D.)	H E M A T O L O G Y/ O N C O L O G Y	IN
DR. CHRISTOPHER P BUNCE (MD)	-	IN
AMELIA FLICK (MD)	A N E S T H E S I O L O G Y	IN
LORI LEEDS (CRNA)	-	IN
EMILY LEINENBACH (NP)	Nurse Practitioner	IN
MRS. MAGGIE JANE SCHNARR (ACNP)	Nurse Practitioner	IN

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?

The registry entry for Unknown Individual shows NPI 1720073109.

What does inactive NPI status mean for Unknown Individual?

Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.

Which specialty label fits Unknown Individual?

NPPES ties Unknown Individual to Emergency Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.

Which community is linked to Unknown Individual?

Unknown Individual shows a connection to Vincennes, Indiana in registry-derived data.

Who maintains Unknown Individual's record?

Providers certify NPPES data; CMS hosts the public file you are viewing.